#76: Anemia: A Plant-Based Approach To Iron Deficiency

By , On , In Blog, Nutrition, Podcast
This is a podcast about Anemia made by Nikki and Zuzana


As health coaches, we often talk with people and even see clients, who struggle with iron-deficiency anemia after adopting a plant-based diet. It’s common to hear people describe just how much better they felt eating this way until the issue of anemia arose, and they were ‘forced’ to return to eating meat and or taking an iron supplement! 

Now this situation is a bit upsetting —especially when this advice of returning to a standard diet and pumping the body with chemicals comes from their family doctor. As for us, we try to steer anyone who asks about treating anemia toward the most natural solutions – whole food plant-based sources of iron and healthy active lifestyle. 

What is Iron? 

Iron is an essential mineral–a metal to be exact–and its main job is to carry oxygen from our lungs to the rest of our body. Iron is also part of the enzymes that are essential for optimal digestion and overall body health. Without enough iron, red blood cells are fewer and smaller, which means they’re not transporting sufficient oxygen where it needs to go. When this happens, your organs and tissues can’t work as well as they should.

Anemia: A Greek word meaning “without blood” – occurs when the body has a low number of red blood cells (RBCs).

What are the general signs and symptoms of anemia? 

Fatigue and Unusual Tiredness
When your body doesn’t have enough hemoglobin, less oxygen reaches your tissues and muscles, depriving them of energy. In addition, your heart has to work harder to move more oxygen-rich blood around your body, which can make you tired. 

Increased heart rate
In cases of iron deficiency, the heart has to work extra hard to transport oxygen around the body which can lead to irregular or fast heartbeats and even heart murmurs, an enlarged heart or heart failure.

Shortness of Breath (especially when going up inclines)
If you find yourself out of breath doing regular, daily tasks that you used to find easy, such as walking, climbing stairs or working out, iron deficiency could be the reason. 

Pale Skin
Paleness in general or in specific areas such as the face, lips,  lower inner eyelid or nails may be a sign of moderate or severe iron deficiency. This is caused by lower levels of hemoglobin, which gives blood its red color.

Frequent Headaches
This symptom seems to be less common than others and often goes hand in hand with lightheadedness or dizziness. Low levels of hemoglobin in red blood cells mean that not enough oxygen can reach the brain. As a result, blood vessels in the brain can swell, causing pressure and headaches.

Brittle or Spoon-Shaped Fingernails
This is a rare side effect and usually only seen in severe cases of iron-deficiency anemia.

Other Potential Signs:

  • Restless Leg Syndrome
  • Difficulty Concentrating
  • Poor Memory
  • Hypersensitivity to Cold Temperatures
  • Loss Of Appetite
  • Swelling and Soreness of the Tongue and Mouth
  • Low endurance (you run out of “gas” fast)
  • Hair loss
  • Reduced Work Productivity
  • Impaired Memory
  • Impaired Concentration
  • Apathy and Depression
  • Reduced Resistance To Infections (e.g. more frequent colds during winter/change of seasons)

Types Of Anemia

There are several different types of anemia, and that’s why treating this condition can get a bit complicated. 

*NOTE*:  Since we are not doctors and it goes beyond our scope of practice to diagnose or treat specific health conditions, we suggest that you turn to a trusted health practitioner for professional advice. 

With that said…

…today we will talk about two of the most common types of anemia:

1. Iron Deficiency

The human body stores iron mainly in the liver, spleen, marrow, duodenum, and skeletal muscle. Iron deficiency occurs when the body’s stores of iron become depleted, and it no longer has enough iron to make all the red blood cells it needs for optimal oxygen distribution. Some common symptoms of anemia are fatigue, shortness of breath, and frequent bruising. You can get a blood test done to determine if you are iron deficient. 

What Causes Iron Deficiency Anemia?

  • Low iron diet 
  • Blood loss
  • Ulcers 
  • Woman -Heavy Menstruation 
  • Athletes – High Impact Sports + Excessive Sweating 
  • Low vitamin D levels
  • Artificial Sweeteners

Iron Deficiency in Athletes

The more active the person, the more dietary iron she/he needs. Constant impact activity, such as running, reduces iron levels more dramatically than other types of exercise because of the more strenuous hemolysis. With each foot strike, a small amount of blood is released from the damaged capillaries. In time, this will lead to anemia if the runner doesn’t pay close attention to her diet. Iron is also lost through sweat.

What’s the Treatment?

  • Increase iron consumptions 
  • Get Outside – Sunlight 
  • Eat a whole food plant-based diet
  • Avoid highly processed foods 
  • Natural supplements 
  • Use high quality cast iron cookware 

Plant-Based Sources Of Iron 

Don’t Forget Vitamin C

Vitamin C is the trick to aiding iron absorption, so be sure to also consume foods high in Vitamin C, alongside foods high in iron. Leafy greens are particularly helpful. However, too much of those containing oxalic acid (such as spinach, and swiss chard) can interfere with iron absorption, so the best answer is to rotate your leafy greens often. Include a variety of  Vitamin C containing foods –  goji berries, bell peppers, broccoli, citrus fruits, organic berries, camu camu powder, etc. 

Caffeine Can Inhibit Iron Absorption

Drinking tea, coffee and caffeinated pop with meals decrease iron absorption. The polyphenol content of these beverages is responsible for this inhibition. So make sure if you do consume either of these beverages to do so about 30-60 minutes before of after a meal.

Natural Iron-Containing Supplements: 

  • Spirulina 
  • Barley grass juice 
  • Maca 
  • Pure, raw organic cacao

2. Pernicious anemia

This is a condition in which the body can’t make enough healthy red blood cells because it doesn’t have enough vitamin B12 /folic acid or when the intestines cannot properly absorb vitamin B12. Without enough vitamin B12 and folic acid, your red blood cells don’t divide normally and are too large. They may have trouble getting out of the bone marrow—a sponge-like tissue inside the bones where blood cells are made.

Today many people vegetarians, vegan as well as omnivores are deficient in B12. 

B12 is a microbe, a bacteria that lives in your stomach. A healthy gut is essential because even if you are getting enough B12 through your diet, this bacteria won’t survive in an unhealthy environment. In that case, B12 is often blocked and not adequately absorbed and distributed into the bloodstream.  As we previously discussed, B12 is essential to help form healthy red blood cells. 

How do you if you are B12 deficient? 

Get tested for B12 deficiency – either with a urine test, homocysteine blood test or methylmalonic acid test.

What Causes Pernicious Anemia? 

With pernicious anemia, it is most likely due to chronic digestive problems and certain autoimmune disorders (Crohn’s disease, Celiac disease, IBS). 

Causes and triggers for that could be:

  • eating a meat/fish/poultry/eggs/cheese/milk diet
  • irregular sleeping habits that upset the melatonin/serotonin cycles and disrupt most other hormones in the body
  • poor hydration
  • medical drugs, including aspirin and other painkillers
  • eating the main meal in the evening instead of at midday
  • using antibacterial cleaners, sanitizers, antibiotics 
  • ignoring digestive troubles  
  • smoking, alcohol 
  • antacid drugs 
  • chemical exposure which includes eating non-organic foods, chemtrails 
  • stress 
  • or a combination of them

What’s the Treatment?

  • Fix your gut
  • Spend more time in a natural environment 
  • Gardening – in a healthy soil 
  • Cleanliness obsession – play in nature – get dirty
  • Drinking from a natural water stream (not recommended unless you know that the source is not polluted) 
  • Eating raw plant-based foods – organic 
  • Include  Foods rich in B12 – sea vegetables, barley miso, tempeh, natto, tamari, parsley, shitake mushrooms,
  • Some studies suggest that foods (irritants) – garlic, onions, hot peppers – inhibit or make it harder to absorb b12 (do your research) 
  • Nutritional yeast also contains B12 however we don’t relay on it due to the fungal potential


Iron Rich Recipes:

Iron-Rich Green Juice 
Red Detox Juice
Hulk Smoothie Bowl
Avocado Goji Pudding
Goji Berry + Ginger Smoothie
Goji & Wild Rice Bowl
Lentil Quinoa Loaf
Wild Rice & Hummus Collard Wraps
Light Vegan Chana Masala

Additional resources:

Hematology | Types of Anemias 
B12 Deficiency & Supplementation 
Risk Associated with Iron Supplements

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Dedicated to your health & wellbeing, 



2 responses to “#76: Anemia: A Plant-Based Approach To Iron Deficiency

  1. Your article offers excellent advice for those who follow a plant based diet. What to do when nothing seems to work ? I eat beans, lentil powder, raisins, kale, oats, nutritional yeast and 25 mg of elemental iron supplement everyday. I take the iron supplement first thing in the morning on an empty stomach combined with a sizable dose of vitamin C. Blood tests continue to show that I am borderline iron deficient. I don’t feel ill – no pain, no unusual fatigue, no signs of anything malignant in my digestive tract. I seem to have come to the end of the road and don’t know where to go from here. Your advice would be greatly appreciated.

    • Hello Frank,

      Thank you for your comment. Nutritionally speaking, it seems that you are getting enough iron through your diet. So next step would be to look at digestion and absorption.

      With pernicious anemia, it is most likely due to chronic digestive problems and specifically due to atrophic gastritis. Causes and triggers for that could be:

      eating a meat/fish/poultry/eggs/cheese/milk diet
      irregular sleeping habits that upset the melatonin/serotonin cycles and disrupt most other hormones in the body
      poor hydration
      eating the main meal in the evening instead at midday, etc. etc.
      or a combination of them.
      Many medical drugs, including aspirin and other painkillers, can cause it.

      You mention that all appears well with the digestive system – I would investigate further. How is the microbiom in the gut, health of the liver, etc.

      Hope this helps.

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